brains

I fell asleep last night dreaming of brains, scrolling through MRIs and FLAIRs and DWIs and CT scans*, all imaging modalities that I still find confusing, trying to find lesions and diagnose illnesses with my incredibly limited body of knowledge.

I take back what I said yesterday about a complete lack of thought regarding the patient experiences.  The neurology "bootcamp" lecturers did talk about interacting with patients and other physicians in a better way, and I like that the attendings are advising us on how best to examine patients and how to make them feel comfortable while still getting the information we need.  But the reality of the wards is this: the team in the back is worried about patients' brains, hearts, and kidneys; keeping the patient alive; and doing the best possible medical treatment for the patient, but the patients themselves are worried about the pain in their hands or being hungry.  It was shocking how many patients kept telling me they were hungry, as the physicians have to order the food.  However, it is important because in some conditions, eating or drinking can be dangerous.



*These are all different types of imaging.  CT scans use X-rays and can be used to identify bone and bleeds and can be done rapidly.  MRI, or magnetic resonance imaging, can be used to get more detailed images using strong magnetic fields, but they take longer.  There are different types of MRI that are better at visualizing different parts of the brain (including T1 images, where gray matter appears bright and white matter is dark; T2 images, where white matter is bright; and FLAIRs, which are like T1 but water, such as in the ventricles, is dark).  DWI's are diffusion-weighted imaging, which is an attempt to